Surgical closure of atrial septal defect is a safe and effective procedure with low morbidity and mortality. A right anterior thoracotomy approach is a suitable alternative to that through a median sternotomy and provides superior cosmetic results. Thirty patients at the age of 1 year, 3 months to 49 years underwent repair of atrial septal defects through a right thoracotomy. Twenty-four patients had secundum, three ostium primum, two sinus venosus defect, and one patient had Scimitar's syndrome. Details of the surgical procedure on cardiopulmonary bypass are presented. There was no operative or late mortality, and no morbidity directly related to the alternative approach. All patients or their parents considered the cosmetic result fair or satisfying. The following paper reflects our experience with the thoracotomy approach for repair of atrial septal defects, as well as a critical review of new developments in interventional ASD occlusion techniques.